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Table 7 Cut-off values with sensitivity, specificity, predictive values and accuracy of PASL-MRI and 1H-MRS in identification of epileptogenic zone in patients with FIAE (n= 26)

From: Arterial spin-labelling and magnetic resonance spectroscopy as imaging biomarkers for detection of epileptogenic zone in non-lesional focal impaired awareness epilepsy

Quantitative imaging parameters Cut-off AUC Sensitivity % Specificity % PPV % NPV % Accuracy %
PASL-MRI parameters rCBF (ml/100 g/min) ≤ 64.87 0.957 98.31 92.90 95.97 88.89 94.75
ASLAI % ≥ 5.96% 0.968 96.01 91.70 89.68 95.82 95.78
MV 1H-MRS parameters Metabolite concentration ratios (in ppm) NAA/Cho ≤ 0.78 0.949 93.0 91.7 90.8 92.7 93.94
NAA/Cr ≤ 0.89 0.889 89.3 88.2 92.6 83.3 88.9
NAA/(Cho+Cr) ≤ 0.59 0.977 100 96.9 96.7 100 97.74
MI/NAA ≥ 0.98 0.989 100 96.34 95.38 100 97.86
Glx/NAA ≥ 1.55 0.972 100 96.35 95.68 100 97.24
Glx/Cr ≥ 1.39 0.955 92.06 90.24% 93.88 93.67 94.53
%AF ≥ 9.98% 0.983 100 97.65 98.31 100 98.14
Combined use of ASL-MRI and MV 1H-MRS 100 98.45 97.81 99.6 98.86
  1. PPV positive predictive value, NPV negative predictive value, MV 1H-MRS multi-voxel proton magnetic resonance spectroscopy, ppm parts per million, NAA N-acetylaspartate, Cr creatine, Cho choline, Glx glutamate-glutamine, MI Myo-inositol, ASLAI% arterial spin labelled asymmetry index (percent), %AF percent asymmetry factor, rCBF regional cerebral blood flow, ml milliliter, g grams, min minute